Blink Research Articles

Advancements in Drowsiness Detection: A Review

This review study looks at current advancements in sleepiness detection technologies to address the urgent problem of driving while sleepy leading to accidents. In order to prevent future accidents, it analyzes several approaches and technology and emphasizes how crucial it is to correctly recognize drowsy conditions in drivers. Important results highlight the effectiveness of methods for real-time drowsiness detection such as convolutional neural networks (CNNs), eye aspect ratio (EAR) analysis, and deep learning integration. Additionally, improvements in computer vision algorithms make it possible to precisely analyze facial landmarks and eye blinking patterns, which improves the accuracy of detection systems. In order to protect driver comfort and system reliability, the evaluation emphasizes the importance of non-intrusive fatigue detection techniques while also emphasizing the necessity to reduce false warnings. Remarkably, certain models detect drowsy-eye with an accuracy of above 95%. All things considered, the review emphasizes how important cutting-edge technology is in reducing the risks related to drunk driving, especially deep learning and computer vision algorithms. It promotes the deployment of reliable sleepiness detection technologies in order to increase road safety and reduce accidents brought on by fatigued drivers. Key Words: Drowsiness detection, Eye blink duration, Facial landmark detection, Deep learning algorithms, Computer vision, Eye aspect ratio, Road safety.

A survey on drowsiness detection system with advanced face tracking

To address the increasing dangers associated with driver and worker fatigue, this project introduces an advanced Drowsiness Detection System featuring state-of-the-art face-tracking capabilities. The pressing need for fatigue detection is evident in the alarming figures of 800 annual fatalities and 50,000 injuries resulting from drowsy driving incidents. This research expands the application of the technology to industrial workplaces, where the consequences of drowsiness are equally severe. Our comprehensive approach involves real-time monitoring of facial features, with a focus on eye movements and eyelid patterns. This system goes beyond traditional boundaries, covering drivers and industrial workers operating heavy machinery. By incorporating facial landmarks and introducing the innovative Eyes Aspect Ratio parameter, our technology offers a precise assessment of weariness in individuals within the current frame. This approach enhances safety measures in smart transportation systems and industrial settings. Integrating facial landmarks allows for a nuanced understanding of fatigue, recognizing subtle changes in facial expressions and movements indicative of drowsiness. The Eyes Aspect Ratio parameter, a novel addition, improves weariness assessment precision by considering factors such as eye closure duration, blink frequency, and gaze direction. These outcomes signify a significant contribution to road safety and broader workplace security. By mitigating inherent risks associated with drowsiness among industrial workers, our technology aims to reduce accidents, prevent injuries, and save lives across various occupational settings. The potential impact extends beyond individuals, influencing organizational safety protocols and contributing to the overall well-being of workers in high-risk environments.

Ocular effects of exposure to low-humidity environment with contact lens wear: A pilot study.

To compare the ocular effects of exposure to a low-humidity environment with and without contact lens (CL) wear using various non-invasive tests. Fourteen habitual soft CL wearers were exposed to controlled low humidity (5% relative humidity [RH]) in an environmental chamber for 90 min on two separate occasions. First, when wearing their habitual spectacles and then, on a separate visit, when wearing silicone hydrogel CLs that were fitted specifically for this purpose. All participants had adapted to the new CL prior to data collection. Three non-invasive objective measurements were taken at each visit: blinking rate, objective ocular scatter (measured using the objective scatter index) and ocular surface cooling rate (measured using a long-wave infrared thermal camera). At each visit, measurements were taken before the exposure in comfortable environmental conditions (RH: 45%), and after exposure to environmental stress (low humidity, RH: 5%). CL wearers showed increased blinking rate (p < 0.005) and ocular scatter (p = 0.03) but similar cooling rate of the ocular surface (p = 0.08) when compared with spectacle wear in comfortable environmental conditions. The exposure to low humidity increased the blinking rate significantly with both types of corrections (p = 0.01). Interestingly, ocular scatter (p = 0.96) and cooling rate (p = 0.73) were not significantly different before and after exposure to low humidity. There were no significant two-way interactions between correction and exposure in any of the measurements. CLs significantly increased the blinking rate, which prevented a quick degradation of the tear film integrity as it was refreshed more regularly. It is hypothesised that the increased blinking rate in CL wearers aids in maintaining ocular scatter quality and cooling rate when exposed to a low-humidity environment. These results highlight the importance of blinking in maintaining tear film stability.

End-of-day assessment of asymptomatic versus highly symptomatic soft contact lens wearers.

To investigate differences in key clinical parameters between asymptomatic and highly symptomatic soft contact lens (CL) wearers after 14 h of wear. In this pilot investigation, Phase 1 identified asymptomatic (CLDEQ-8 score ≤ 7) and highly symptomatic (CLDEQ-8 score ≥ 20) subjects after fitting with nelfilcon A CLs. Phase 2 investigated the following over a single nelfilcon A CL-wearing day (14 ± 2 h): blinking characteristics, tear meniscus height (TMH), non-invasive tear break-up time (NIBUT), tear film osmolarity and eyelid margin staining. Parameters for the two groups were compared using linear mixed models and post-hoc testing. The relationship between comfort scores and the clinical parameters was also investigated. Overall, 161 and 42 subjects were enrolled into Phase 1 and 2, respectively. Twenty-five asymptomatic and 17 symptomatic subjects completed Phase 2. Lower eyelid TMH was decreased after 14 h in symptomatic compared with asymptomatic subjects (least square mean [LSM] difference -0.04 mm, 95% CI: -0.07, -0.01). Osmolarity was lower in symptomatic than in asymptomatic subjects at fitting (LSM difference -9.89, 95% CI: -18.91, -0.86). Upper eyelid margin staining was greater after 14 h in symptomatic than in asymptomatic subjects (LSM difference 0.53, 95% CI: 0.01, 1.05) and greater after 14 h than baseline in the symptomatic group (LSM difference 0.61, 95% CI: 0.16, 1.07). There was a significant relationship between comfort and upper eyelid margin staining (r = -0.40, 95% CI: -0.63, -0.11) and blink rate (r = -0.31, 95% CI: -0.57, -0.003). The potential parameters most effective in differentiating asymptomatic from symptomatic wearers were upper eyelid margin staining and lower TMH. The parameter with the strongest relationship to comfort was upper eyelid margin staining, where higher comfort scores were associated with lower levels of staining.

A measure of the blink reflex to parametric variation of mechanical stimulation of the trigeminal nerve.

The primary goal of this study was to develop a parametric model that relates variation in stimulation of the trigeminal nerve to properties of the blink response. We measured blink responses in 17 healthy, adult participants to air puffs directed at the lateral canthus of the eye at five different, log-spaced intensities (3.5-60 PSI). Lid position over time was decomposed into amplitude and velocity components. We found that blink amplitude was systematically related to log stimulus intensity, with the relationship well described by a sigmoidal function. The parameters of the model fit correspond to the slope of the function and the stimulus intensity required to produce half of a maximal blink response (the half-response threshold). There was a reliable increase in the half-response threshold for the contralateral as compared to the ipsilateral blink response. This increase was consistent across participants despite substantial individual differences in the half-response threshold and slope parameters of the overall sensitivity function, suggesting that the laterality effect arises in the neural circuit subsequent to individual differences in sensitivity. Overall, we find that graded mechanical stimulation of the somatosensory trigeminal afferents elicits a graded response that is well described by a simple parametric model. We discuss the application of parametric measurements of the blink response to the detection of group differences in trigeminal sensitivity.

Comparative assessment of pupillary oscillation and blinking rate between emmetropes and myopes

Aim of this study was to investigate for a relationship between pupillary oscillations (PO) and blinking rate (B) in various vision deprived states such as in refractive errors (Myopes).: A case control descriptive study with 340 individuals, including 220 myopes and 120 emmetropes were compared for pupillary oscillation rate (PO), blinking rate (B) and Pupillary oscillation/blinking rate (PO/B) ratio bilaterally in normal as well as in individual subgroups of decreasing visual acuity, done under slit lamp in dim diffuse illumination. The pupillary oscillation rate (PO) was 49.23± 8.80 in right eye (POR) and 56.44 ±8.95 in left eye (POL) in the control group whereas it was 46.28 ±11.55 and 52.79 ±11.22 in the right and left eyes respectively of the cases. While PO/B ratio was 12.41±14.11 in the right eye and 14.33±15.9 in the left eye in control group, it was 7.13 ± 7.86 in the right and 8.18 ±9.07 in the left eye of the cases respectively. The blinking rate (B) was 8.62 ±6.06 in the control eyes and in the cases it was 11.69 ±7.91. The comparative analysis of all of the above parameters were statistically significant with p &amp;#60; 0.001 between cases and controls. POR = POL in 5.0%, POR &amp;#62; POL in 7.50% and POR &amp;#60; POL in 87.50%.: This study could be useful in non-verbal patients and comatose patients as diagnostic and prognostic tool, having an implication in different refractive errors and neurological diseases.

Neurophysiology of hypokinetic movement’s disorders: New insights in daily clinical practice

Hypokinetic movement disorders encompass a group of clinically similar diseases that present challenges in discrimination during neurological examinations. Characterizing a specific hypokinetic disorder is necessary for the diagnosis and treatment in daily clinical practice. Neurophysiological tools, such as electromyography (EMG) combined with accelerometry, motor-evoked potentials (MEPs), electroencephalographic recording (EEG), Bereitschaftspotential (BP), auditory-evoked cognitive potential (P300), blink reflex (BR), and R2 blink reflex recovery cycle (R2BRRC), are useful in the differential diagnosis of movement disorders due to the common clinical features. However, neurophysiological assessments of movement disorders, especially hypokinetic diseases, are currently underutilized in clinical practice as compared to a few decades ago. This review aims to summarize practical insights gleaned from reported studies over the past 5 years (i.e., 2019 &amp;ndash; 2023) regarding neurophysiological assessments of hypokinetic movement disorders, emphasizing the importance of their routine application. In particular, the methodology of the electrophysiologic evaluations pertaining to hypokinetic movement disorders is assessed. Moreover, a practical approach for the differential diagnosis of similar movement disorder syndromes based on specific neurophysiological features is proposed. Collectively, this review of the most recent neurophysiological implications in hypokinetic movement disorders highlights the practicality of these methods. Despite the advancement of other diagnostic techniques (e.g., neuroradiological methods), neurophysiological assessments may be a promising tool for clinical diagnoses, due to their high accuracy and ability to categorize and manage movement disorders (e.g., hypokinetic movement disorders) in daily clinical practice.

Clinical study of esodeviations in children

Esotropia or convergent strabismus is a common type of squint in children. The esodeviation, the refractive error and the amblyopia should be examined and treated early to achieve good cosmetic correction and to improve Visual acuity.A meticulous history of 25 children up to age of 12 years who presented with esodeviations was taken including the age of onset, duration and previous treatment. They were examined for amount and type of deviation by cover test, hirschberg corneal reflex test, Prism bar cover test and evaluated for refractive error under full cycloplegic correction, for Binocular Single Vision, diplopia, suppression and amblyopia by Worth four-dot test and RAF ruler. Ocular movements and fundus findings were recorded.11 male and 14 female children with esodeviations with age of presentation varying from 9 months to 12 years were evaluated for type of esotropia. In our study the most common type seen in 12 cases (48%) is refractive accommodative esotropia with high hypermetropia. Non-refractive accommodative esotropia greater for near with high AC/A ratio in 5 patients (20%), Partially accommodative (mixed) esotropia in 2 cases, acquired non-accommodative esotropia seen in 2 patients. 1 case each is seen in Infantile esotropia, in Sensory esotropia, in child with Duane’s retraction syndrome (DRS) and in child having cerebral visual impairment (CVI).Our study aimed to diagnose and manage the various types of esodeviations at an early age so as to maintain binocular alignment and a good Visual acuity to avoid progression to amblyopia.

A nationwide survey of facial onset sensory and motor neuronopathy in Japan

The epidemiology and etiology of facial onset sensory and motor neuronopathy (FOSMN), a rare syndrome that initiates with facial sensory disturbances followed by bulbar symptoms, remain unknown. To estimate the prevalence of FOSMN in Japan and establish the characteristics of this disease, we conducted a nationwide epidemiological survey. In the primary survey, we received answers from 604 facilities (49.8%), leading to an estimated number of 35.8 (95% confidential interval: 21.5–50.2) FOSMN cases in Japan. The secondary survey collected detailed clinical and laboratory data from 21 cases. Decreased or absent corneal and pharyngeal reflexes were present in over 85% of the cases. Electrophysiological analyses detected blink reflex test abnormalities in 94.1% of the examined cases. Immunotherapy was administered in 81% of cases and all patients received intravenous immunoglobulin. Among them, 35.3% were judged to have temporary beneficial effects evaluated by the physicians in charge. Immunotherapy tended to be effective in the early stage of disease. The spreading pattern of motor and sensory symptoms differed between cases and the characteristics of the motor-dominant and sensory-dominant cases were distinct. Cases with motor-dominant progression appeared to mimic amyotrophic lateral sclerosis. This is the first nationwide epidemiological survey of FOSMN in Japan. The clinical course of FOSMN is highly variable and motor-dominant cases developed a more severe condition than other types of cases. Because clinical interventions tend to be effective in the early phase of the disease, an early diagnosis is desirable.

Superior orbital fissure syndrome after deep lateral orbital wall decompression in Graves’ ophthalmopathy

ABSTRACT Purpose The superior orbital fissure contains cranial nerves III, IV, VI, and V1 with their three branches: frontal, lacrimal, and nasociliary. Superior orbital fissure syndrome (SOFS) is rare and can occur as a result of compression of these nerves due to trauma, bleeding, or inflammation in the retrobulbar space, but no cases of SOFS after deep lateral orbital wall decompression (DLOWD) have been reported. The aim of this paper is to describe this pathology, its possible causes, management, and outcome. Methods Retrospective study of 575 DLOWD in patients with disfiguring exophthalmos due to Graves’ ophthalmopathy performed in our hospital between 2010 and 2023. Three cases of postoperative SOFS were identified based on clinical presentation, history, physical examination, and radiological study. All patients were observed for a minimum of 12 months. Results SOFS was diagnosed with the presence of ophthalmoplegia, ptosis, fixed and dilated pupils, hypo/anesthesia of the upper eyelid and forehead, loss of corneal reflex, and no loss of vision after DLOWD. Fractures, edema, and hemorrhages were excluded. They were treated with high-dose intravenous steroids and the patients recovered completely. Conclusions DLOWD challenges orbital surgeons because it requires removing bones near the globe or neurovascular structures. SOFS may occur due to the proximity and increased pressure on these structures.

Stay Alert: Drowsiness Detection with IoT Technology

The "Drowsiness Detection using IoT with Eye Blink Sensor and Buzzer" project aims to address the critical issue of driver fatigue and drowsiness, a major cause of road accidents. Leveraging Internet of Things (IoT) technologies and a combination of eye blink sensors and a buzzer, this system provides a real-time solution for monitoring and alerting drivers when signs of drowsiness are detected. The project focuses on enhancing road safety by preventing accidents caused by driver fatigue Drowsiness detection is a critical aspect of ensuring safety, particularly in domains such as transportation where fatigue-related accidents pose significant risks. In recent years, the proliferation of Internet of Things (IoT) devices has enabled innovative approaches to drowsiness detection systems. This abstract outlines a novel framework for drowsiness detection utilizing IoT technologies. Our proposed system integrates various sensors, including facial recognition cameras, heart rate monitors, and accelerometers, into a networked IoT infrastructure. These sensors continuously monitor key physiological and behavioral indicators associated with drowsiness, such as eye movement patterns, blink frequency, heart rate variability, and head position changes.

The effect of polyethylene cover intervention on ocular surface disorder of intensive care unit patients: a systematic review and meta-analysis

BackgroundPolyethylene covers have been proven to be effective in protecting the eyes in patients with decreased or disappeared blink reflexes, but their advantages compared to other conventional methods are still unclear. This systematic review and meta-analysis study aimed to elucidate the impact of polyethylene covers in the prevention of ocular surface disease (OSD) in patients admitted to the intensive care unit (ICU).MethodsWe searched the Scopus, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify randomized controlled trial studies. This study followed the PRISMA guidelines and used the Cochrane Collaboration tool to assess the risk of bias.ResultsThe findings were expressed as risk ratio (RR) with 95% confidence intervals. The incidence of OSD in the polyethylene cover group was lower than that in the eye drops group (RR = 0.27; 95% CI (0.07, 1.09), P = 0.07) and adhesive tape group (RR = 0.11, 95%CI (0.04, 0.31), P < 0:0001) but the polyethylene cover group showed no significant difference compared to the eye gel group (RR = 0.79, 95%CI (0.18, 3.51), P = 0.76) and the eye ointment group (RR = 0.85; 95% CI (0.36, 1.99), P = 0.71).ConclusionThis study showed that polyethylene covers, eye gels, and eye ointments had an equal effect on preventing OSD in ICU patients, and eye drops and adhesive tapes were relatively less effective. However, other intervention methods had not been compared due to the small number of articles. Hence, further studies should assess the available methods to choose the best practical method.

Blink rate during saccadic eye movements: insights from patients with chronic pain.

Chronic pain (CP) significantly impacts quality of life and poses an increasing economic burden on healthcare systems worldwide. This study investigates the relationship between blink rate during saccadic eye movements and pain perception in patients with CP. Ninety-two patients with CP (24 men, 68 women) were assessed using eye-tracking technology during horizontal and vertical saccadic tasks. Pain perception was evaluated using the Central Sensitization Inventory - Part A and the McGill Pain Questionnaire, and anxiety levels were measured using the State-Trait Anxiety Inventory. The results revealed a significant correlation between blink rates in horizontal and vertical tasks (ρ = 0.668, P < 0.001). However, there was no correlation between blink rate and age, pain perception, or anxiety scores. Conversely, measures of pain perception were positively correlated with each other and with anxiety scores. These findings suggest that while blink rate may reflect oculomotor function, it is not directly influenced by pain perception or anxiety in patients with CP. The present study highlights the potential of eye tracking for the comprehensive assessment and management of patients with CP.

Face and liveness detection with criminal identification using machine learning and image processing techniques for security system

&lt;p&gt;In the past, real-world photos have been used to train classifiers for face liveness identification since the related face presentation attacks (PA) and real-world images have a high degree of overlap. The use of deep convolutional neural networks (CNN) and real-world face photos together to identify the liveness of a face, however, has received very little study. A face recognition system should be able to identify real faces as well as efforts at faking utilizing printed or digital presentations. A true spoofing avoidance method involves observing facial liveness, such as eye blinking and lip movement. However, this strategy is rendered useless when defending against replay assaults that use video. The anti-spoofing technique consists of two modules: the ConvNet classifier module and the blinking eye module, which measure lip and eye movement. The results of the testing demonstrate that the developed module is capable of identifying various face spoof assaults, including those made with the use of posters, masks, or smartphones. To assess the convolutional features in this study adaptively fused from deep CNN produced face pictures and convolutional layers learned from real-world identification. Extensive tests using intra-database and cross-database scenarios on cutting-edge face anti-spoofing databases including CASIA, OULU, NUAA and replay-attack dataset demonstrate that the proposed solution methods for face liveness detection. The algorithm has a 94.30% accuracy rate.&lt;/p&gt;

Assessing multi-domain impact of IAQ and noise on productivity with portable air cleaners through physiological signals

The office environment's indoor air quality (IAQ) and noise levels are critical factors that affect productivity and overall health. However, a research gap still exists on multi-domain impact of IAQ and noise on human physiological signals. The research aims to establish a comprehensive understanding of the multi-domain impact by analyzing physiological signals such as Electroencephalogram (EEG), Electrodermal Activity (EDA), eye blinks, jaw clenching, and heart rate. 30 human subjects participated in a series of tests in various indoor environments with portable air cleaner configurations. The study incorporated four scenarios with baseline condition and two noise levels. By comparing the different scenarios, the separate and combined impacts of IAQ and noise on office productivity were assessed. Meanwhile, physiological signals were collected and analyzed alongside productivity tests, which included typing and addition tasks, to determine the relationship between IAQ, noise, and office productivity. We discovered a strong relationship between EEG power and productivity, indicating that EEG power was a valuable indicator for evaluating indoor environmental quality, especially the multi-domain effects of IAQ and noise. When using the air cleaner, the relative power in the Theta, Alpha, and Beta bands indicated increased concentration and activity levels in the brain. Additionally, the increasing number of jaw clenching suggested that participants became more anxious and nervous in noisy environments. We also found that there were no gender differences for the analysis of EEG power, providing insights for future research. These findings have implications for smart control and built environment aimed at enhancing office workers' well-being and productivity.

Blink reflex changes in patient with long COVID headache

Background: Headache is a common symptom of long COVID. Blink Reflex (BR) may indicate possible brainstem dysfunction or changes in excitability in the headache. In this study, we aimed to reveal whether one of the underlying mechanisms of headache in long COVID is dysfunction in the nociceptive centers in the brainstem. Methods: The study included 29 individuals with confirmed 2019 coronavirus disease (COVID-19) and 17 healthy volunteers. Individuals were divided into 3 groups: post-COVID-19 headache (Group 1), post-COVID-19 headache-free (Group 2) and healthy individuals (Group 3). Individuals in the groups were subjected to BR and the parameters obtained with BR were compared between the 3 groups. Results: Accordingly, when Group 1 and Group 2 were compared, the mean latency of the R1 component of the BR and the mean latency of the ipsilateral R2 component obtained via right-sided electrical stimulation were found to be longer in Group 1. When Group 1 and Group 3 were compared, the latency differences of the ipsilateral R2 component and contralateral R2 component of the BRs were found to be longer in Group 3, indicating distinct patterns of neural response between the two groups. Conclusion: In long COVID patients experiencing headache symptoms, the underlying cause of the pain symptom may be brain stem dysfunction.

What is a blink? Classifying and characterizing blinks in eye openness signals

Blinks, the closing and opening of the eyelids, are used in a wide array of fields where human function and behavior are studied. In data from video-based eye trackers, blink rate and duration are often estimated from the pupil-size signal. However, blinks and their parameters can be estimated only indirectly from this signal, since it does not explicitly contain information about the eyelid position. We ask whether blinks detected from an eye openness signal that estimates the distance between the eyelids (EO blinks) are comparable to blinks detected with a traditional algorithm using the pupil-size signal (PS blinks) and how robust blink detection is when data quality is low. In terms of rate, there was an almost-perfect overlap between EO and PS blink (F1 score: 0.98) when the head was in the center of the eye tracker’s tracking range where data quality was high and a high overlap (F1 score 0.94) when the head was at the edge of the tracking range where data quality was worse. When there was a difference in blink rate between EO and PS blinks, it was mainly due to data loss in the pupil-size signal. Blink durations were about 60 ms longer in EO blinks compared to PS blinks. Moreover, the dynamics of EO blinks was similar to results from previous literature. We conclude that the eye openness signal together with our proposed blink detection algorithm provides an advantageous method to detect and describe blinks in greater detail.

Exploring Superstitious Beliefs Among Educated Urban Population

Technical revolutions and scientific advancements are conspicuous, but still, false beliefs and superstitious behaviour are quite commonplace. It could be believed that these beliefs are held by less educated people. Therefore, the present study investigated superstitions among educated urban people. Using a qualitative research method, data was collected through interviews and analyzed through thematic analysis. A total of 8 participants (i.e., 2 males and 6 females) participated in the study. All of the participants were highly educated (16 years’ education or above). A purposive sampling technique was used to include participants in this research. Detailed semi-structured interviews were conducted with each participant with their consent. Seven themes were derived including brooming, marriage fixing, palm itching, eye blink, glass break, lucky stones, and lucky numbers. The study recommends inculcating scientific knowledge on a broader level in Pakistan.

Combined cortical thickness and blink reflex recovery cycle to differentiate essential tremor with and without resting tremor.

To investigate the performance of structural MRI cortical and subcortical morphometric data combined with blink-reflex recovery cycle (BRrc) values using machine learning (ML) models in distinguishing between essential tremor (ET) with resting tremor (rET) and classic ET. We enrolled 47 ET, 43 rET patients and 45 healthy controls (HC). All participants underwent brain 3 T-MRI and BRrc examination at different interstimulus intervals (ISIs, 100-300 msec). MRI data (cortical thickness, volumes, surface area, roughness, mean curvature and subcortical volumes) were extracted using Freesurfer on T1-weighted images. We employed two decision tree-based ML classification algorithms (eXtreme Gradient Boosting [XGBoost] and Random Forest) combining MRI data and BRrc values to differentiate between rET and ET patients. ML models based exclusively on MRI features reached acceptable performance (AUC: 0.85-0.86) in differentiating rET from ET patients and from HC. Similar performances were obtained by ML models based on BRrc data (AUC: 0.81-0.82 in rET vs. ET and AUC: 0.88-0.89 in rET vs. HC). ML models combining imaging data (cortical thickness, surface, roughness, and mean curvature) together with BRrc values showed the highest classification performance in distinguishing between rET and ET patients, reaching AUC of 0.94 ± 0.05. The improvement in classification performances when BRrc data were added to imaging features was confirmed by both ML algorithms. This study highlights the usefulness of adding a simple electrophysiological assessment such as BRrc to MRI cortical morphometric features for accurately distinguishing rET from ET patients, paving the way for a better classification of these ET syndromes.

Ocular surface changes following computer use in post-LASIK patients.

To assess the impact of computer use on the ocular surface of individuals after laser insitu keratomileusis (LASIK). The dry eye symptoms and ocular surface of 18 post-LASIK young individuals and 18 controls were evaluated before and after performing a 30-min task on a computer without (Visit 1) and with (Visit 2) initial instillation of artificial tears. Symptoms were assessed using the Ocular Surface Disease Index (OSDI), Symptom Assessment in Dry Eye questionnaire version two (SANDE II) and Computer Vision Syndrome Questionnaire (CVS-Q). The ocular surface was assessed by measuring corneal higher order aberrations, tear meniscus height (TMH), conjunctival redness, blink rate and incomplete blinking, lipid layer thickness (LLT) and non-invasive keratograph break-up time (NIKBUT). SANDE II scores were >0 after the computer task in both groups (p ≤ 0.01). SANDE II and CVS-Q scores did not differ between LASIK and controls (p ≥ 0.43). Greater bulbar-temporal conjunctival redness, TMH and LLT and shorter NIKBUT were found after computer use in the LASIK group (p ≤ 0.04), whereas no changes were observed in the controls (p ≥ 0.20). Lower SANDE II and CVS-Q scores were reported at Visit 2 compared with Visit 1 in both groups (p ≤ 0.01). Likewise, no worsening of dry eye signs was observed at Visit 2 (p ≥ 0.11). Ocular symptoms reported during computer use were comparable between the groups. However, a worsening of dry eye signs was mostly observed in post-LASIK individuals. The instillation of artificial tears was effective in preventing the effects of computer use on the ocular surface in post-LASIK patients.